Psilocybin, a Naturally Occurring Indoleamine Compound, Could Be Useful to Prevent Suicidal Behaviors

Current interventions for people at risk of suicide have limited efficacy. This review examines whether psilocybin, a psychedelic compound with a long history of human use, could modulate thoughts and behavioral patterns in individuals at risk of suicidal behaviors. The authors summarize evidence that psilocybin directly stimulates the serotonin 2A receptor (5HT2A), targeting inflammatory and oxidative stress pathways, which may lead to rapid increases in brain plasticity, cognitive flexibility, spirituality, and empathy, while suppressing inflammation. Preliminary epidemiological data are presented, and the review calls for clinical studies to test psilocybin in individuals with suicidal ideation or at risk of suicidal behaviors.

Study at a glance

Abstract

The available interventions for people who are at risk of suicide have limited efficacy. Recently, research on new mental health treatments has started to consider psychedelic compounds, particularly psilocybin, a molecule with a few thousand years of history of use in human societies. The possible effects of psilocybin on suicidal ideation and behaviors have not been specifically studied yet; however, the current knowledge on the suicidal process and the available data on es/ketamine suggest that psylocibin could be used to modulate the thoughts and behavioral patterns in individuals who are at risk of suicidal behaviors. Here, we summarize the available evidence on the possible mechanisms underlying psilocybin positive effects on suicide risk. Major pathways related to suicidal behaviors that might be modulated by psylocibin include serotonin receptors. Specifically, psylocibin directly stimulates the serotonin 2A receptor (5HT2A), targeting the inflammatory and oxidative stress pathways and leading to a rapid increase in brain plasticity and inflammation suppression and increases in cognitive flexibility, spirituality, and empathy. We also present preliminary epidemiological data and provide a rationale for studying psilocybin in individuals with suicidal ideation or who are at risk of suicidal behaviors. This review presents a framework to understand the basis for psilocybin use in individuals who are at risk of suicidal behaviors and calls for clinical studies.